Efficacy comparison of multi-phase CT and hepatotropic contrast-enhanced MRI in the differential diagnosis of focal nodular hyperplasia: a prospective cohort study
Abstract Background Different clinical behaviour influences the importance of differentiating focal nodular hyperplasia (FNH) from other focal liver lesions (FLLs). The aim of this study was to compare the efficacy of contrast-enhanced CT and MRI in the diagnosis of FNH. Methods 157 patients with eq...
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BMC
2018-01-01
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| Series: | BMC Gastroenterology |
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| Online Access: | http://link.springer.com/article/10.1186/s12876-017-0719-1 |
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| author | Tomasz K. Nowicki Karolina Markiet Ewa Izycka-Swieszewska Katarzyna Dziadziuszko Michal Studniarek Edyta Szurowska |
| author_facet | Tomasz K. Nowicki Karolina Markiet Ewa Izycka-Swieszewska Katarzyna Dziadziuszko Michal Studniarek Edyta Szurowska |
| author_sort | Tomasz K. Nowicki |
| collection | DOAJ |
| description | Abstract Background Different clinical behaviour influences the importance of differentiating focal nodular hyperplasia (FNH) from other focal liver lesions (FLLs). The aim of this study was to compare the efficacy of contrast-enhanced CT and MRI in the diagnosis of FNH. Methods 157 patients with equivocal FLLs detected in ultrasonography subsequently underwent multi-phase CT and MRI with the use of hepatotropic contrast agent (Gd-BOPTA) in a 1.5 T scanner. Examinations were evaluated by three independent readers. Diagnostic efficacy of different radiological signs of FNH in both CT and MRI was compared and AFROC analysis was performed. Results 4 hepatocellular adenomas, 95 hepatocellular carcinomas, 98 hemangiomas, 138 metastases and 45 FNHs were diagnosed. In both CT and MRI the radiological sign of the highest accuracy was the presence of the central scar within FNH (0.93 and 0.96 relatively). The sum of two radiological signs in MRI: homogeneous enhancement in hepatic arterial phase (HAP) and enhancing lesion in hepatobiliary phase (HBP) was characterized with high values of sensitivity (0.89), specificity (0.97), PPV (0.82), NPV (0.98) and accuracy (0.96). After inclusion of clinical data into analysis the best discriminating feature in MRI was the presence of enhancing lesion in HBP in patients without cirrhosis. In this regard, efficacy parameters increased to 1.00, 0.99, 0.94, 1.00 and 0.99 accordingly. The area under the curve in AFROC analysis of MRI performance was significantly larger than of CT (p = 0.0145). Conclusion Gd-BOPTA-enhanced MRI is a more effective method in the differential diagnosis of FNH than multi-phase CT. |
| first_indexed | 2024-12-13T01:22:20Z |
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| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-13T01:22:20Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
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| series | BMC Gastroenterology |
| spelling | doaj.art-61f5212d0cc64a7e928cd4b2a82a47262022-12-22T00:04:13ZengBMCBMC Gastroenterology1471-230X2018-01-011811910.1186/s12876-017-0719-1Efficacy comparison of multi-phase CT and hepatotropic contrast-enhanced MRI in the differential diagnosis of focal nodular hyperplasia: a prospective cohort studyTomasz K. Nowicki0Karolina Markiet1Ewa Izycka-Swieszewska2Katarzyna Dziadziuszko3Michal Studniarek4Edyta Szurowska52nd Departement of Radiology, Medical University of Gdansk2nd Departement of Radiology, Medical University of GdanskDepartment of Pathology and Neuropathology, Medical University of Gdansk2nd Departement of Radiology, Medical University of GdanskDepartement of Radiology, Medical University of Gdansk2nd Departement of Radiology, Medical University of GdanskAbstract Background Different clinical behaviour influences the importance of differentiating focal nodular hyperplasia (FNH) from other focal liver lesions (FLLs). The aim of this study was to compare the efficacy of contrast-enhanced CT and MRI in the diagnosis of FNH. Methods 157 patients with equivocal FLLs detected in ultrasonography subsequently underwent multi-phase CT and MRI with the use of hepatotropic contrast agent (Gd-BOPTA) in a 1.5 T scanner. Examinations were evaluated by three independent readers. Diagnostic efficacy of different radiological signs of FNH in both CT and MRI was compared and AFROC analysis was performed. Results 4 hepatocellular adenomas, 95 hepatocellular carcinomas, 98 hemangiomas, 138 metastases and 45 FNHs were diagnosed. In both CT and MRI the radiological sign of the highest accuracy was the presence of the central scar within FNH (0.93 and 0.96 relatively). The sum of two radiological signs in MRI: homogeneous enhancement in hepatic arterial phase (HAP) and enhancing lesion in hepatobiliary phase (HBP) was characterized with high values of sensitivity (0.89), specificity (0.97), PPV (0.82), NPV (0.98) and accuracy (0.96). After inclusion of clinical data into analysis the best discriminating feature in MRI was the presence of enhancing lesion in HBP in patients without cirrhosis. In this regard, efficacy parameters increased to 1.00, 0.99, 0.94, 1.00 and 0.99 accordingly. The area under the curve in AFROC analysis of MRI performance was significantly larger than of CT (p = 0.0145). Conclusion Gd-BOPTA-enhanced MRI is a more effective method in the differential diagnosis of FNH than multi-phase CT.http://link.springer.com/article/10.1186/s12876-017-0719-1Focal nodular hyperplasiaMagnetic resonance imagingComputed tomographyDifferential diagnosisHepatobiliary phaseGadobenate Dimeglumine |
| spellingShingle | Tomasz K. Nowicki Karolina Markiet Ewa Izycka-Swieszewska Katarzyna Dziadziuszko Michal Studniarek Edyta Szurowska Efficacy comparison of multi-phase CT and hepatotropic contrast-enhanced MRI in the differential diagnosis of focal nodular hyperplasia: a prospective cohort study BMC Gastroenterology Focal nodular hyperplasia Magnetic resonance imaging Computed tomography Differential diagnosis Hepatobiliary phase Gadobenate Dimeglumine |
| title | Efficacy comparison of multi-phase CT and hepatotropic contrast-enhanced MRI in the differential diagnosis of focal nodular hyperplasia: a prospective cohort study |
| title_full | Efficacy comparison of multi-phase CT and hepatotropic contrast-enhanced MRI in the differential diagnosis of focal nodular hyperplasia: a prospective cohort study |
| title_fullStr | Efficacy comparison of multi-phase CT and hepatotropic contrast-enhanced MRI in the differential diagnosis of focal nodular hyperplasia: a prospective cohort study |
| title_full_unstemmed | Efficacy comparison of multi-phase CT and hepatotropic contrast-enhanced MRI in the differential diagnosis of focal nodular hyperplasia: a prospective cohort study |
| title_short | Efficacy comparison of multi-phase CT and hepatotropic contrast-enhanced MRI in the differential diagnosis of focal nodular hyperplasia: a prospective cohort study |
| title_sort | efficacy comparison of multi phase ct and hepatotropic contrast enhanced mri in the differential diagnosis of focal nodular hyperplasia a prospective cohort study |
| topic | Focal nodular hyperplasia Magnetic resonance imaging Computed tomography Differential diagnosis Hepatobiliary phase Gadobenate Dimeglumine |
| url | http://link.springer.com/article/10.1186/s12876-017-0719-1 |
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